Connecting the Dots: A Functional Medicine Approach to Treating Hypertension

A Case Study from Kara Fitzgerald, ND.

Kara will be speaking on this topic at our conference on 29th October, few seats are still available, book here.

A 62-year-old gentleman named Robert presented to my office recently with a diagnosis of hypertension and hyperlipidemia. He was about to retire from a lifetime of high-stress, demanding technical work. He was motivated to improve the quality of his health so he could maximize enjoyment of his later years with family and friends. (What a fabulous goal!) He presented to me as a relatively healthy American male, balding with mild abdominal adiposity. His blood pressure (left arm sitting) was 130/85. He had moderate hearing loss requiring hearing aids in both ears as a result of receiving ototoxic antibiotics as a small child. He had his hearing checked at regular intervals, which generally showed no change or a slight decline. He ate a relatively healthy diet, lots of nuts and seeds, good fish and veggies. He loved bread and frequently indulged the desire with rolls and baguettes. He enjoyed sweets occasionally.  As a former runner, he was of the mind that “carbo-loading” was a good thing, even though he wasn’t exercising with the same intensity or frequency of his youth. He took an ACE inhibitor and a statin at standard dosages. His family history included heart disease and diabetes. Significant symptoms are noted in his baseline Medical Symptom Questionnaire (MSQ) which can be viewed here.

In my practice, I cast a wide biochemical net with laboratory analysis and I use the IFM Matrix to “see inside” my patients to identify what they need to thrive. The Matrix is a systems medicine data sorting tool that is indispensable to my work (see: www.functionalmedicine.org for more information). The Matrix is an organized a set of core clinical imbalances that are linked to the basic physiological processes. These serve to marry the mechanisms of disease with the manifestations and diagnoses of disease. Many common underlying pathways of disease are reflected in these clinical imbalances. The Matrix components include: Assimilation Imbalances, Biotransformation and Elimination Imbalances, Defense and Repair Imbalances, Energy Imbalances, Communication and Transport Imbalances, Structural Integrity Imbalances and Mind, Emotions and Spiritual Imbalances. As the greater medical community embraces individualized, systems-thinking, this model (or similar) will likely be widely adopted.

With Robert, I ordered a comprehensive battery of standard labs, including: chemistry screen, complete blood count, lipid, thyroid and iron panels; insulin, celiac serology and HLA genes, fibrinogen, homocysteine, hs-CRP, Lp(a) and testosterone. Nutrient testing included: amino acids, organic acids, lipid peroxides, essential and toxic elements, vitamin D, E, CoQ10, A, beta carotene, fatty acids, stool microbiota analysis with digestive markers; IgG4 food sensitivities. To identify key areas of imbalance and treatment direction, I placed the significant laboratory findings along with his clinical history and treatment into a table comprised of the key Matrix imbalances (Table 1).

Table 1. Assessments, Laboratory Findings and Treatments Organized According to the Functional Medicine Matrix
Clinical Assessment	Initial Laboratory Results	Initial Recommended Treatment
Fundamental Lifestyle Factors: Nutrient Imbalances
Hypertension Maldigestion/malabsorption (MSQ: GI)	Low B12 (elevated urinary methylmalonic acid) Low serum COQ10 Low serum vitamin D Low fecal elastase (poor digestion)	Methylcobalamin 5000ug SL QD CoQ10 300mg PO QD D3 5000IU PO QD HCL 500mg titrate to tolerance Digestive enzymes: 2 with main meals
Defense and Repair (e.g. Immune, Inflammation, Infection/microbiota)
Food allergies/sensitivities  Dysbiosis History of antibiotics Intestinal hyperpermeability (MSQ: GI, Joint, Energy) Environmental allergies (MSQ: Nose) Hypovitaminosis D	Celiac gene: HLADQ2 Low serum vitamin D IgG4 testing” +3 to dairy, mild positives 5 additional foods Stool testing: microbiota imbalance, low fecal elastase	Vitamin D3, Digestive enzymes, HCL – as noted in “Nutrient Imbalances” Glutamine-based GI repair powder Probiotic combination:100 billion CFU per day Dietary changes: Lower carbohydrate, gluten and dairy-free, minimal sugar, protein at all meals. Whole foods, minimally processed, organic diet. Rotate mild reactants.
Assimilation (e.g. Digestion, Absorption, microbiota/GI, Respiration)
Dysbiosis History of antibiotics Intestinal hyperpermeability Maldigestion/malabsorption (MSQ: GI )	Celiac gene: HLADQ2 (Celiac serology negative) IgG4 testing” +3 to dairy, mild positives 5 additional foods Stool testing: microbiota imbalance	As noted in “Defense and Repair”
Communication (e.g. Endocrine, Neurotransmitters, immune messengers)
Hypertension Hyperlipidemia Family history of heart disease and diabetes	Low HDL Low-normal free testosterone High-normal fasting blood glucose (thyroid panel, essential elements and amino acids all within normal limits)	Dietary changes as noted in “Defense and Repair” Cardiovascular exercise prescription DHEA 50mg PO QD
Energy (e.g. Energy Regulation, Mitochondrial Function)
MSQ: fatigue Statin rx	Low serum vitamin D Low serum CoQ10 B12 deficiency (cardiovascular, inflammatory and oxidative markers all within normal limits)	Alpha lipoic acid 200mg: 1 tab TID As noted in “Nutrient Imbalances”
Mental, Emotional, Spiritual
High-stress work life	N/A	Pending retirement Exercise prescription

 

Robert adhered to all of the treatment recommendations. His complaints largely resolved, as seen in his follow-up MSQ below. He was able to discontinue his medications. His blood pressure was on average around 110/70. He lost over 20 pounds and became an avid hiker. His success inspired those around him, including his wife and sons, who all moved towards a healthier lifestyle.

As part of the Matrix model, questions we can ask while we are sorting the data that allow us to drill down into and differentiate between the causes and effects of the disease are: what are the ANTECEDENTS, TRIGGERS and MEDIATORS of the disease process in this individual? Understanding the “ATMs” helps us to zero in on areas needing evaluation. When designing treatments, ask: what does our patient NEED TO GET RID OF; what does our patient need to GET?

This case is interesting in that hypertension, Robert’s chief complaint when he presented to me, really didn’t require direct intervention. Rather, an investigation of ATMs led to the identification of a possible pre-celiac malabsorptive condition that likely caused the subtle nutrient deficiencies that contributed to his high blood pressure. A positive finding of the celiac genes without celiac serology has been termed gluten sensitivity and is associated with IBS and non-specific lymphocytic infiltration of the gastrointestinal mucosa (REF). Indeed, when Robert trialed a reintroduction of gluten, his GI symptoms returned and his blood pressure increased. Thus, we could say that the celiac HLADQ2 gene was an antecedent factor, as was his family history of heart disease and diabetes. A disease trigger and mediator in this case could be the ongoing consumption of gluten, which probably contributed to the malabsorptive state. He also noticed a clear correlation with sweets and blood pressure. Gluten intolerance-induced nutrient insufficiency and sugar ingestion have both been associated with hypertension.

Interestingly, it was noted that Robert had lost ½ inch in height at his annual physical exam. A bone density test (DXA scan) revealed osteopenia, also associated with celiac-induced malabsorption.

A final twist to this case is that Robert’s most recent hearing test revealed a mild, but significant improvement, a remarkable finding considering the duration and cause of the impairment. While it cannot be determined what contributed to the improvement specifically, a systems- rather than a symptom- approach to his treatment favors the occurrence of such an event.

For detailed, referenced cases using The Institute for Functional Medicine’s Matrix including extensive laboratory analysis and case discussion, see the updated Textbook for Functional Medicine. Also see: Case Studies in Integrative and Functional Medicine, Fitzgerald and Bralley, published by Metametrix Institute, 2011

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Book Review: Case Studies in Integrative and Functional Medicine

Editors Kara Fitzgerald and J. Alexander Bralley

This is a fantastic addition to the evidence base for a functional and integrative approach to medicine.

The book is a collection of case studies, taken from a wide range of clinicians, across a variety of complex medical conditions. Each case outlines how functional laboratory tests were used to reveal core imbalances linked to the basic physiology of the individual and how the treatment plans implemented led to significant improvements in symptoms.

Although the book is divided into sections based on type of condition (atopic, autoimmune, cardiovascular etc), what’s clear is that each of the individual case subjects were treated as individuals; the clinician in each case used their clinical skills, supported by insight from the laboratory testing, to consider the individual biochemical imbalances, and by working through those, was able to bring about real change and improvement.

Comprehensive discussion and reference are provided each case, so we have the blend of clinical experience and scientific evidence to support the decision-making.

As a UK clinician how can this book support you? It puts functional medicine, or a functional approach to health care into perspective; it provides practical and evidenced support on how to use this approach in dealing with complex cases. Whether you an experienced clinician or recently qualified, this book will provide insight on unlocking challenging cases. As Mark Hyman, IFM chair comments ‘Doctors must learn through apprenticeship, example and case histories. These functional medicine case studies are the next best thing to being a master’s apprentice, a window into the thinking behind the practical application of functional medicine”

I hope this book can also help to share the functional or integrative approach we take with other healthcare providers, to foster a collaborative approach to chronic health problems.

The book is available to purchase here

Angela Walker BSc Nut Med mBANT CNHC registered

Technical Advisor, Nutrition Geeks

Statin Drugs, Cholesterol and Heart Disease: Myth versus Reality

We’re delighted to introduce our first ever guest ‘post’, from By Dicken Weatherby, N.D. and Donald R. Yance, MH, CN. Dicken will be speaking at the upcoming BANT seminar we are hosting on 29th October, read on for a taster of what to expect!

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Pfizer and Merck are continuing their efforts to have the commonly prescribed Statin medications Lipitor and Mevacor approved for over the counter use. Currently these drugs are made available in the US only with a physician’s prescription. In the US, the Food and Drug Administration or FDA has turned down three times Merck’s application to make Mevacor, one of the first statin drugs, available without a prescription. The panel that made this decision the third time raised concerns that patients would turn to statin drugs instead of seeking a physician’s care. It’s good news that the FDA isn’t giving the green light to widespread over-the-counter drug use despite the heavy sway of advertising that would have people believe statin drugs are a safe panacea for preventing cardiovascular disease. We know most of you reading this already understand the misinformation being foisted on the public regarding statin drugs, but we thought we’d take this opportunity to review some the myths and the realities behind this issue so you can properly consult with your patients and clients.

Dispelling some of the myths regarding statin drugs, cholesterol and heart disease:

MYTH 1

“High cholesterol (and LDL) is the number-one cause of heart disease in the West.”

Wrong. High cholesterol is among the risk factors for heart disease, but is not the leading risk factor. The most prevalent risk factor is low HDL, along with small LDL particles, which commonly occur together. In fact, of every 100 people with coronary heart disease, 60-70 will have low HDL and small LDL particles, but fewer than 30 will have high LDL. If this is the case, why do we not hear more about low HDL and small LDL particles? The answer is simple: because treating these is not as profitable for drug companies. But just wait—when a profitable drug becomes available to treat this more prevalent risk factor for heart disease, we can expect to hear about an “epidemic” that will justify billions of dollars in new drug expenditures.^1-4

What qualifies as low HDL? National guidelines say it is a level of less than 40 mg/dL for men and less than 45 mg/dL for women.⁵ In fact, a level of less than 60 mg/dL is probably very significant.⁶ HDL is already a standard measure in everyday cholesterol panels. Small LDL particles, on the other hand, need to be measured specifically. The medical world focuses on statin therapy for LDL, while the most prevalent risk factor for heart disease goes untreated in the great majority of cases.

MYTH 2

“If I take a statin agent, I won’t have a heart attack.”

This is simply untrue. Lowering cholesterol (even to rock-bottom levels) reduces, but does not eliminate, the risk of heart attacks. Many heart attacks still occur in people with low cholesterol levels, whether or not they take cholesterol-lowering drugs.⁷ We must consider that there are other risk factors for heart disease besides cholesterol, such as small LDL particles, low HDL, high fibrinogen, high homocysteine, and high insulin levels. Results from the most recent National Health and Nutritional Survey show that 47 million US adults have metabolic syndrome (low HDL, high triglycerides, high blood pressure, excess abdominal fat), which substantially heightens the risk of heart disease even in the presence of low cholesterol levels.⁸

MYTH 3

“I feel fine and my stress test was normal. My doctor says I don’t have heart disease.”

This is among the most widely propagated fallacies spread by many primary care physicians and even cardiologists. First, lack of symptoms should not be reassuring, as most heart disease is silent—without symptoms and undetectable by conventional means such as electrocardiograms and cholesterol testing. Second, stress testing is a miserable failure for screening asymptomatic people. Most future deaths and heart attacks, in fact, occur in people with normal stress tests (when symptoms are not present). The net result of this misperception is that most future heart-attack victims are walking around feeling fine and unaware of their risk.⁹ Cholesterol can be high, low, or in between, but all too frequently fails to shed light on this murky situation.

Cholesterol: the lipid with a bad reputation

Hyperlipidemia refers to elevated blood levels of lipids (fats), including cholesterol and triglycerides. Most people with hyperlipidemia have no symptoms. However, hyperlipidemia is a contributing factor associated with an increased risk of coronary heart disease (CHD), a thickening or hardening of the arteries that supply blood to the heart muscle. CHD, in turn, can result in angina pectoris (chest pain), a heart attack, or both.  Although hyperlipidemia is considered a risk factor to heart disease, it is one of many risk factors and what actually causes hyperlipidemia is a debatable issue.  It not as simple as foods that contain cholesterol, elevate lipids.

Another important risk factor, which has been largely overlooked, is the oxidation of low-density lipoprotein (LDL) cholesterol caused from a lack of antioxidant-rich foods, herbs, and nutrients and/or a large intake of foods and chemicals that contains damaging free radicals.  Chronic inflammation also contributes to oxidative stress and an increase in CHD.  When LDL cholesterol oxidizes, it promotes atherosclerosis by a process referred to as the macrophage-foam cell mechanism, particularly in the presence of stressors, like cortisol and insulin.  Cortisol and insulin together act as a dynamic duel causing all kinds of disruptions including an increased oxidative and inflammatory state.  These are the real underline causes to chronic disease.  Inflammation is also involved in the process of LDL oxidation and contributes to the development of vascular disease. ^10-13 Ideally LDL levels should be kept under 120 mg/dL and you should monitor your patients for oxidative activity, especially lipid peroxidation.

The production of C-reactive protein is an essential part of the inflammatory process, and the measurement of this substance reflects the level of inflammatory activity deep within the body. It appears that certain conditions create a state of excessive inflammation within the circulatory system. High C-reactive protein levels are evidence of this type of inflammation. ^14-17 Ideally it is best to keep C-reactive protein levels below 0.55 mg/L in men and 1.5 mg/L in women. Please note that the reference ranges above refer to the High Sensitivity CRP or hs-CRP test.

Multiple risk markers for atherosclerosis and cardiovascular disease act in a synergistic way through inflammatory pathways.  The following lists the different factors that have been identified as risk factors for CHD and arterial damage:

1. Elevated CRP
2. Elevated LDL
3. Excess Insulin
4. Low HDL
5. High Glucose
6. Nitric Oxide Deficit
7. Excess Triglycerides
8. Low Free Testosterone
9. Excess Fibrinogen
10. Excess Homocysteine
11. Hypertension
12. Low Vitamin K
13. Excess Cholesterol

There are many key inflammatory biochemical risk markers for cardiovascular disease; in particular, the role of three basic cell types affected by these risk markers (endothelial cells, smooth muscle cells, and immune cells), the crucial role of inflammatory mediators, nitric oxide balance in cardiovascular pathology, and the use of nutrients (flavanoids, carotenoids, sterols, vitamin C and E, Omega 3 fatty acids etc.) to circumvent several of these inflammatory pathways. Most of the above risk markers for cardiovascular disease have a pro-inflammatory component, which stimulates the release of a number of active molecules such as inflammatory mediators, reactive oxygen species, nitric oxide, and peroxynitrite from endothelial, vascular smooth muscle, and immune cells in response to injury. Nitric oxide plays a pivotal role in preventing the progression of atherosclerosis through its ability to induce vasodilation, suppress vascular smooth muscle proliferation, and reduce vascular lesion formation. Nutrients such as arginine, antioxidants (OPCs, vitamins C and E, lipoic acid, selenium, glutathione), and enzyme cofactors (vitamins B2 and B3, B6, B12, folate, zinc) help to elevate nitric oxide levels and may play an important role in the management of cardiovascular disease. Other dietary components such as DHA/EPA from fish oil, tocotrienols, vitamins B6 and B12, and quercetin contribute further to mitigating the inflammatory process.  ¹⁸

Within the broad range of cholesterol levels from 180 to 240 there is little to no evidence that this alone correlates with heart disease. Below 180 there is increased risk of hemorrhagic stroke, depression, and suicide. Above 240 there is increased risk of cardiovascular disease and ischemic stroke. Over age 70, elevated cholesterol and cardiovascular events no longer correlate. All told, total serum cholesterol alone is a poor indicator of cardiovascular disease. Half of all heart attack patients have normal total cholesterol levels.

So, not only do statin drugs have their inherent drawbacks, but in some ways they are treating a fabricated problem based on misunderstood and misrepresented “research”. As natural health care providers, we know that we must be wary of the current cholesterol hysteria, we must be able to explain the real evidence, and we must help our patients understand the facts so they can make educated health choices.

Dicken Weatherby, ND is originally from Oxfordshire in the UK and is based in Ashland, Oregon USA. A graduate of the National College of Natural Medicine, Dicken is author of the bestselling book Blood Chemistry and CBC Analysis-Clinical Laboratory Testing from a Functional Perspective. He has self-published seven other books in the field of alternative medical diagnosis, has created numerous information products, and runs a number of successful Web sites including http://www.FMTown.com, an online membership community for practitioners interested in Functional Medicine and Functional Diagnosis. Dr. Weatherby is the creator of the “Foundations of Functional Diagnosis Training Program” at www.FunctionalDiagnosis.com and the “Foundations of Functional Blood Chemistry Analysis” Training Program at www.BloodChemistryTraining.com.

 

Donald R. Yance, CN, MH, RH is an internationally known herbalist and nutritionist. He is the founder and medical director of the Centre for Natural Healing in Ashland, Ore. Through extensive research and clinical practice, he has developed his Triphasic system, which forms the cornerstone of his clinical approach. Donald is the founder and formulator of Natura Health Products, and founder and president of The Mederi Foundation, whose programs promote health education and clinical research on the use of natural medicine, with an emphasis in the field of integrative oncology.

This article was also published in the BANT newsletter September 2011

 

 

 

References

1. Gardner CD, Fortmann SP, Krauss RM. Association of small low-density lipoprotein particles with the incidence of coronary artery disease in men and women. JAMA. 1996 Sep 18;276(11):875-81.
2. Stampfer MJ, Krauss RM, Ma J, et al. A prospective study of triglyceride level, low- density lipoprotein particle diameter, and risk of myocardial infarction. JAMA. 1996 Sep 18;276(11):882-88.
3. Lamarche B, Tchernof A, Moorjani S, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men: Prospective results from the Quebec Cardiovascular Study. Circulation. 1997 Jan 7;95(1):69-75.
4. Kuller L, Tracy P, Arnold A, et al. Nuclear magnetic resonance spectroscopy of lipoproteins and risk of coronary heart disease in the cardiovascular health study. Arterioscler Thromb Vasc Biol. 2002 Jul 1;22(7):1175-80.
5. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.
6. Gotto AM, Brinton EA. Assessing low levels of high-density lipoprotein cholesterol as a risk factor in coronary heart disease. J Am Coll Cardiol. 2004 Mar 3;43(5):717-24
7. van Lennep JE, Westerveld HT, Van Lennep HW, Zwinderman AH, Erkelens DW, van der Wall EE. Apolipoprotein concentrations during treatment and recurrent coronary artery disease events. Arterioscler Thromb Vasc Biol. 2000 Nov;20(11):2408-13.
8. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002 Jan 16;287(3)356-9.
9. Taylor AJ, Merz CN, Udelson JE. 34th Bethesda Conference: “Can atherosclerosis imaging techniques improve the detection of patients at risk for ischemic heart disease?” J Amer Coll Cardiol. 2003 Jun 4;(11)41:1860-2.
10. Rifai N, Ridker PM, Inflammatory markers and coronary heart disease. Curr Opin Lipidol 2002      Aug;13(4):383-9.
11. Albert CM, et al, Prospective study of C-reactive protein, homocysteine, and plasma lipid levels as predictors of sudden cardiac death. Circulation 2002 Jun 4;105, (22):2595-9.
12. Bermudez EA, Ridker PM, C-reactive protein, statins, and the primary prevention of atherosclerotic cardiovascular disease. Prev Cardiol 2002 Winter;5(1):42-6.
13. Schroecksnadel K, Frick B, Winkler C, Fuchs D. Crucial role of interferon-gamma and stimulated macrophages in cardiovascular disease. Curr Vasc Pharmacol. 2006 Jul;4(3):205-13
14. Rifai N, Ridker PM, Inflammatory markers and coronary heart disease. Curr Opin Lipidol 2002      Aug;13(4):383-9.
15. Albert CM, et al, Prospective study of C-reactive protein, homocysteine, and plasma lipid levels as predictors of sudden cardiac death. Circulation 2002 Jun 4;105      (22):2595-9.
16. Bermudez EA, Ridker PM, C-reactive protein, statins, and the primary prevention of atherosclerotic cardiovascular disease. Prev Cardiol 2002 Winter;5(1):42-6.
17.  Blake GJ, Ridker PM, Inflammatory mechanisms in atherosclerosis: from laboratory evidence to clinical      application. Ital Heart J 2001 Nov;2(11):796-800.
18. Osiecki HE. The role of chronic inflammation in cardiovascular disease and its regulation by nutrients. Altern Med Rev. 2004 Mar;9(1):32-53

New Gut Frontiers

© Devonsun - Fotolia.com

As a nutritional therapist I know it’s more a case of you are what you can digest than simply what you eat. I’m always grilling my clients on their digestive health and know, as many of you will, that good gut health is paramount to optimal health and wellness.

So I’ve been excited to read about some of the latest research collaborations and directions expanding our knowledge into the fascinating depths of the human gut and it’s role in human health.

The bacteria in our gut contain millions of microbial gene, the microbiome, which interact with the human genes to create a ‘super organism’[1]. In a recent review article a team from Imperial Collage highlighted that the microbiome has a direct influence on the pathology of a huge, wide variety of conditions and disease states including autism, asthma, depression, hypertension, peripheral vascular disease, obesity, biliary disease as well as usual suspects IBD and colon cancer. It’s also been shown that the microbiome can affect an individual’s metabolism and therefore response to medications. This has a huge implication for personalised health care in the future and supports what many of us have learnt from our own training and clinical practice, that gut flora can be modulated for the benefit of health.

A number of research groups are working on establishing a core microbiome, i.e. the essential bacterial species or strains within humans that may be essential to optimal health. One of these, the MetaHIT project, is undertaking the biggest census of the bugs living inside our guts. The European study has taken samples from 124 subjects; a mixture of healthy, overweight and people suffering with inflammatory bowel disease (IBD) and identified the genes of the intestinal microbials. So far, they’ve found 3.3 million different genes from the samples taken, that’s 150 times more genes than in the human genome. About 40% of those are shared with at least 50% of the group, so we all have a core of the same bacteria in out guts. Each individual in the study has at least 160 different bacterial species. An ongoing part of the study is to look at the function of these bacteria and work out which are contributing to our health and which seem to be more present in those with bowel disease or with obesity[2] What is clearly emerging is that human health is a function of our human genes, our environment AND our microbiome and once again, we know we can assess and then modulate the microbiome via functional stool testing, probiotics, prebiotics, dietary intervention and appropriate anti-microbial agents.

© WONG SZE FEI - Fotolia.com

The Rome Foundation[3] has a mission to improve the lives of people with functional GI disease. Two of their working teams are looking at areas which have great relevance and interest to our field.

One team led by Magnus Simren is looking into ‘the role of the intestinal microbiota in functional gastrointestinal disorders’. One of their aims is to establish whether patients with IBS have abnormal colonic bowel flora and small intestine bacterial overgrowth. To have this established in a peer reviewed large-scale review would be really significant. They plan to publish their review by the end of the year so watch this space!

The second team has a remit to explore the role of food and diet in IBS type problems. The project synopsis recognises that while many IBS sufferers suspect the involvement of food with their symptoms (e.g. symptoms worsen after meals) there is little recognition of food involvement amongst many medical practitioners, in part due to lack of robust empirical evidence on the link. Once again this could be very significant in helping to build a larger empirical evidence base for the role of food in functional bowel problems

Three Metametrix test profiles to consider:

GI Effects stool test offers comprehensive PCR/DNA based analysis of gut microbiota for greater accuracy of aerobes and anaerobes and greater sensitivity for yeasts and parasites.

Organix dysbiosis profile measures the by products of bacterial and yeast metabolism excreted in the urine.

Blood spot IgG4 offers a convenient way to assess delayed IgG4 immune responses to common foods.

All available from Nutrition Geeks exclusively in the UK, for more information visit www.nutritiongeeks.co.uk

Angela Walker BSc Nut Med mBANT CNHC registered

Technical Advisor, Nutrition Geeks

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[1] Kinross et al (2011) Gut Microbiome-host interactions in health and disease Genome Medicine 3:13

[2] Qin et al A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 464, 59-65

[3] http://theromefoundation.org

Home Sweet Home!

It’s a phrase most can identify with. It speaks of the comfort, familiarity, and security most people associate with their regular place of dwelling. It’s uttered most often when returning home from a vacation or a stressful, long day at work.

Home Bittersweet Home…

While there’s no doubt most people hold positive emotional and spiritual ties with their home, science has uncovered that the average home can be a source of hazardous chemicals and toxins. The new Everyday Exposures interactive home website is an innovative addition to theMetametrix website, designed to help educate consumers and clinicians alike about some of the common and not so common toxins in the everyday home.

Toxic Home

A quick glance at the Interactive Toxic Home will allow users to see the common toxins that are present in different rooms and areas of the home. Move your cursor over different parts of rooms such as furniture or flooring to see their associated toxins and learn more about each one. Where applicable, you can also find information about how to get tested for exposure to the particular class of toxin from the menu across the bottom.

Over-The-Top!

Over-exaggerating or going to extremes you might say? Surely my home doesn’t contain the full array of toxins described on this website. Or perhaps you’re pessimistic about the health risks that toxins in the home pose to the average individual. You might argue that the average dwelling in western civilizations has not changed significantly in the last few decades, so why should we be any more concerned about toxins in the home now than say 30 or 40 years ago?

Increasing Toxin Stores

As it turns out, there are classes of toxins in the home that have been shown to bioaccumulate in human tissue. That means the amount of toxin stored in tissues increases over time. A good example comes from a study of the level of polybrominated diphenyl ethers (PBDEs) in the milk of individual US mothers. PBDEs are used in a range of commercial products as flame retardants, and trace amounts are present in the tissues of virtually every individual in western society. The study showed increases of PBDEs in adipose tissue of several hundred per cent over 10 years.[1]

Risks of Acute and Chronic Exposure

While toxins such as PBDEs, which are very pervasive in modern day society are hard to escape, there are other classes of toxins, such as solvents, phthalates, and parabens which are easier to avoid in the home environment. The risk posed from exposure to such toxins really does depend on the individual and the home. As you would expect, moving into a new home or undertaking home renovations can present increased health risks to susceptible individuals. But what should we make of the health risks from continued exposure to the wide range of toxins in the home over years and decades?

Model Toxic Tradesman

One way to get some idea is to look at the extreme end of the spectrum with tradesmen such as painters, carpenters, furniture and cabinet makers, etc. A study of 1,000 male Finnish painters and 1,000 carpenters found highly significant associations between cumulative intensity of long-term solvent exposure and symptoms of memory, concentration, and mood. Exposure was also associated with diagnosed psychiatric disorders, hypertension, and arrhythmia. One important point to note from the study was that recent exposure was found to have no major effects on symptoms.[2]

In an even larger study involving over 52,000 subjects from Singapore, occupational factors were found to contribute to a significant fraction of respiratory diseases such as asthma and chronic bronchitis. Exposure to simple things such as dusts from cotton, wood, metal, minerals, and asbestos was associated with non-chronic cough, phlegm, chronic bronchitis, and adult-onset asthma.[3]

Outworking Toxin Exposure through Biochemical Individuality

The studies cited above involved subjects exposed to relatively high levels of different types of toxins associated with various building products. The average individual who is not a tradesman is not likely to experience such high levels of exposure. However, we know from the principal of biochemical individuality that exposure to the same toxin at the same level in two individuals with different diets, genetics, and different physical and social environments will likely have different physical effects.

Obvious Candidates for Toxin Testing

If you are an individual that can trace the onset of any respiratory or neurological symptoms with a change in the location of your home or workplace, then you are an obvious candidate for appropriate toxin assessment using the Toxic Effects Profiles. Similarly, recent renovations, changes to furniture, flooring, or insulation can trigger symptoms associated with increased toxin exposure. Check out the new Interactive Toxic Home to see which toxins may be implicated.

Toxic Health Insurance

But what if you’re an individual in relatively good health with no obvious respiratory or neurological symptoms for that matter? Well, assuming that quality of life as opposed to length of life are of value to you, there is sufficient research and evidence to suggest that continued long-term exposure to the range of toxins in the average household can be detrimental to your health in some capacity. Why not consider taking the appropriate Toxic Effects Profiles for a holistic assessment of the threats to your long-term health? ~ Wesley Hurrell

CONTACT US

For more information on the Metametrix Toxicity Profiles, please contact Nutrition Geeks

References

1. Shecter A, et al. Polybrominated diphenyl dthers (PBDEs) in U.S. mothers’ milk. Environ Health Perspect.2003; 111:1723–1729.
2. Kaukiainen A, et al. Solvent-related health effects among construction painters with decreasing exposure. Am J Ind Med. 2004;46(6):627-36.
3. LeVan TD, et al. Vapor, dust, and smoke exposure in relation to adult-onset asthma and chronic respiratory symptoms: the Singapore Chinese Health Study. Am J Epidemiol. 2006;163(12):1118-28.

Welcome to Nutrition Geeks

Welcome to the blogsite of Nutrition Geeks.

At Nutrition Geeks we are serious about providing you with the best functional laboratory tests and research driven nutritional supplements formulated by professionals for professionals.

A new approach to healthcare is emerging which looks at the underlying causes of dysfunction rather than symptoms and named disease. Referred to as Functional Medicine or Integrative Medicine, this approach focuses on identifying and addressing nutritional, metabolic and gastro-intestinal imbalances as well toxin effects that underlie chronic disease.

Who we work with

We offer functional laboratory tests, nutritional supplements and education to clinicians and healthcare professionals in the UK and Europe.

For clinicians and health care professionals we can take you from investigation of underlying issues with our functional laboratory tests through to clinical solutions via our research driven nutritional supplements. We also have a wealth of education resources available on laboratory evaluations, functional medicine and nutritional supplements.

For members of the public and patients we can offer the testing services and nutritional supplements as long as you are already working with a clinician or health care professional.

What is our role?

Laboratory Testing: All laboratory work is undertaken by Metametrix Clinical Laboratory in Atlanta, US. We are the appointed exclusive UK distributor for Metametrix as well as distributing to select European countries. Once a test has been completed, the results will be made available to the ordering clinician. Nutrition Geeks do not have access to any of the test results. All patients must therefore speak to their clinician or healthcare professional for their test results.

If patients don’t have a clinician,  you can search for one of our registered clinicians through the find a clinician tool. Alternatively you can speak to one of our own clinicians through Nutrition Geeks Clinic.

Supplements: Our supplement range from Designs for Health is designed by professionals for professionals. They are exclusive to Nutrition Geeks in the UK and are only available through a clinician or healthcare professional. Nutrition Geeks cannot advise on supplements, you must speak to your clinician or healthcare professional regarding how long to take supplements for and dosage.